Company Overview

The York Street Project was established to empower homeless and economically disadvantaged women and children, helping them break free from the cycle of poverty and achieve self-sufficiency. Through a network of interconnected programs focused on housing, education, and childcare, the organization provides vital support to those in need within its community.

Job Summary

The Health Services Coordinator plays a critical role in advancing York Street Projects capacity to deliver Medicaidreimbursable housing supports and health-related services. This position ensures continuity of coverage, coordinates with managed care organizations (MCOs), maintains compliance and quality assurance, and bridges operations across programs. The coordinator manages paperwork and billing workflows (via Foothold Technologies and MCO claim systems), monitors program integration, and supports the organizations compliance and documentation standards.

Responsibilities

Participant Coverage & Insurance Oversight

• Verify, monitor, and maintain insurance eligibility, enrollment, and coverage status for participants.
• Proactively address lapses in coverage and assist participants with renewal or new
• enrollment processes.
• Coordinate with internal staff and external partners to resolve coverage issues (e.g.,Medicaid, managed care).
• Serve as liaison with state Medicaid agencies or MCOs regarding participant coverage concerns.

Compliance, Quality Assurance & Program Integration

• Lead development and monitoring of compliance policies and procedures consistent with Medicaid, state, and contract requirements.
• Oversee QA and QI initiatives, including utilization management and performance metrics.
• Ensure coordination of health-related services across York Street Project programs (shelter, education, childcare, housing).
• Monitor adherence to documentation standards, clinical protocols, and audit readiness.

Billing, Reconciliation & Reporting

• Manage timely submission of claims, encounter forms, and required paperwork to MCOs and Medicaid.
• Oversee monthly billing reconciliation processes in Foothold Technologies and MCO portals.
• Track denials, rejections, and appeals; coordinate with finance to resolve billing issues.
• Prepare regular reports (monthly, quarterly) on billing, utilization, and revenue performance.

Credentialing & Contracting Interface

• Assist in credentialing and contracting processes with MCOs (e.g., document preparation, follow-up, monitoring).
• Coordinate with legal and contracting specialists to review and ensure favorable contract terms.
• Monitor expiration dates, recredentialing deadlines, and provider maintenance requirements.

Training & Capacity Building

• Provide training and technical assistance to staff on Medicaid documentation, billing, eligibility, and compliance.
• Serve as internal resource for staff questions related to health services, insurance, and MCO processes.
• Update and distribute training materials and job aids.

Other Duties

• Participate in strategic planning for expansion into health-related service lines or Medicaid provider types.
• Collaborate with external stakeholders (MCOs, state agencies, contracted providers) on policy and operational matters.
• Maintain awareness of regulatory changes, Medicaid waivers, and managed care updates.
• Perform other related tasks as assigned.

Qualifications & Skills

Education & Experience

• Bachelors degree in Public Health, Health Administration, Social Work, Nursing, or related field (Masters preferred).
• Minimum 35 years experience in healthcare coordination, managed care, Medicaid billing, or similar role. Prior experience with MCOs, Medicaid programs, credentialing, or health services billing strongly preferred.

Knowledge & Competencies

• Strong understanding of Medicaid, managed care, credentialing, utilization management, and compliance principles.
• Experience with billing systems, claims submission, and reconciliation (preferably human services/social supports).
• Familiarity with Foothold Technologies, HMIS, or EHR systems preferred.
• Excellent communication, analytical, and data reporting skills.
• Strong organizational, training, and problem-solving skills.
• Commitment to trauma-informed, culturally responsive service delivery.